Together with her husband Jeffrey, Ellie Zuehlke anticipated the arrival of her first child with joy and excitement. Instead, she became one of the many women who experience postpartum depression. Ellie became a ghostly presence in her own home, disconnected from her son and husband and experiencing thoughts of suicide. With a combination of talk therapy, medication, and everyday support, Ellie emerged intact, crediting Minneapolis psychiatrist Dr. Helen Kim with saving her life. Now, three years later, Ellie and Jeffrey are expecting a second child and have a treatment plan in place.

Interview

Prior to having your son, did you have any knowledge about postpartum depression? For example, did your OB/GYN discuss it with you, or did any friends or family members experience it?
I had some level of awareness about postpartum depression, and most pregnancy books seem to have a paragraph or two addressing the topic. But I certainly did not think it applied to me! I was far more concerned with the health of my baby, and doing everything I could to make sure that he was born healthy. I don't recall specifically discussing PPD with my OB/GYN.

It turns out that I knew quite a few people who had experienced PPD, however, I didn't know it at the time. It was not until I had PPD that people confided in me that they too had suffered through it. It was tremendously helpful to me to know that I was not alone, and that some bright, capable women whom I admired had been where I was and made it through. I hope that by openly sharing my story I might be able to help other women as these women helped me, as well as work to break down the taboo around mental illness.

You've shared that your depression hit thirteen days after delivering your son. Did your mood progressively worsen over those first two weeks, or was there a singular, defining moment where you recognized your depression?
That time was such a blur, but what I do remember is that I did have the "baby blues" for the first week or so postpartum but was still able to function. It was when I was no longer able to sleep, completely lost my appetite, starting vomiting several times a day, and experienced a panic attack that it was clear that something was really wrong. Another thing I noticed was that I was unable to cry. Ironically, it was not until I started to recover that I was able to cry again.

Describe a typical day in the throes of this disorder.
What I remember most about those days was feeling like my body was moving through wet concrete - slow, heavy, and utterly exhausted - but my mind was racing and spinning out of control like tires on a sheet of ice. Mornings were the most painful part of the day. I would get out of bed and vomit and had no appetite whatsoever. Even the thought of trying to eat was distressing, but I did my best to try to eat something.

I really don't know how to describe the pain that depression creates, except to say that is excruciating and persistent. I really struggled with simple daily tasks, even showering and getting dressed. Routine things like driving were out of the question. I did the best I could to help take care of my son, but the reality was that I could barely care for myself. My husband stayed home with me for several months, as I did not feel safe being left alone or capable of taking care of my son.

Afternoons were a little easier for some reason, and I made sure to get outside and get some exercise - I started by walking, and eventually was able to resume running. While physically I was exhausted, exercise definitely provided some relief. I longed to nap, but if I tried to lay down my mind would start racing and often I would throw up.

Evenings were really hard as bedtime was extremely stressful. Sleep was a major issue for me, and even with the handful of medications I took every night to help me sleep, falling asleep - and staying asleep - for more than a few hours was very difficult. Sleep was something I craved intensely - I was so tired, and so sleep deprived, and it provided some reprieve from the pain - but my mind fought fiercely against it. I would say that sleep was the hardest single part about PPD for me.

What was the most challenging or surprising element about postpartum depression?
I guess the most surprising part about PPD for me was how debilitating it was. If you had asked me before what I thought PPD was like, I probably would have said something like 'feeling sad all of the time.' I never would have guessed how painful it was, the impact on my physical health, or how it made my mind unreliable. I think the hardest and most surprising part about recovery was how long it took, and the 'crisis of confidence' I experienced as I once again was able to trust my thoughts and judgment. Through other challenges - such as running marathons, or the unmedicated birth of my son - I could rely on my mind and my thoughts to help me make it successfully through. It was very frightening to no longer be able to trust myself when I had PPD.

We know that you worked successfully with Dr. Kim. What kind of therapy was most effective for you?
For me, it was a combination of therapies that really helped. Medication was very important in my case. Ultimately, it was a combination of an antidepressant and an atypical antipsychotic that helped the most. While I have chosen to remain on a smaller dose of the antidepressant long-term, I only needed the antipsychotic and other medications for a few months.

Therapy was another key piece of treatment for me. At first, it was largely about providing support while I suffered the worst of the PPD and the appropriate combination of medications was identified. I spent several weeks in a partial hospitalization program, followed by several weeks of therapy several times per week. Guided imagery was particularly helpful in calming my racing thoughts during that time. I still see my therapist every six weeks or so. This has been particularly important recently as we plan for the birth of our second child.

Later in my recovery, I attended a 12-week mindfulness meditation course and learned techniques for stress reduction and calming my mind. I would highly recommend meditation to anyone, whether or not depression is an issue.

You're expecting another baby this year; congratulations! What do you currently do to maintain good mental and physical health?
Eating well, getting enough sleep, and exercising is tremendously important for maintaining not only my physical health, but mental health as well. Running outdoors is my preferred form of exercise, but at this point in my pregnancy I have switched to walking and using the elliptical trainer at the gym, and prenatal yoga.

Finally, making spending time with my friends and family, and my son Graham a top priority is essential for maintaining good mental health and enjoying life!